Hindfoot blast injuries caused by improvised explosive devices: long-term functional assessment in French military personnel

Anaïs Chataigneau, Alexia Milaire, Paul-Vincent Martin, Julien Danis, Fabrice Bazile, Nicolas de l'Escalopier, Laurent Mathieu

Int Orthop. 2021 Mar;45(3):751-757

Purpose: The chosen treatment and long-term evaluation of hindfoot blast injuries are not well-represented in the literature. The first objective of this retrospective study was to evaluate functional outcomes in French service personnel who had sustained such injuries caused by improvised explosive devices. The second objective was to compare the results for patients who had amputations with those who did not. The hypothesis was that amputee recovered better function.

Methods: Long-term functional evaluations were carried out using the American Orthopaedic Foot and Ankle Society scale (AOFAS), the Foot and Ankle Ability Measure (FAAM), and the Short Form 12 health survey (SF-12).

Results: Eight servicemen with ten hindfoot blast injuries were reviewed at a mean follow-up time of seven years. Primary management was always conservative although half of the patients required late amputation for chronic pain. The patients who underwent amputation reported significantly lower levels of pain than those who did not have an amputation, with higher FAAM and SF-12 scores.

Conclusion: In this series, long-term functional results appear better in the amputated group.